Individual
JOHN WILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15600 S. U.S. HWY 441, B, SUMMERFIELD, FL 34491
(352) 307-0073
(352) 307-2073
Mailing address
15600 S. U.S. HWY 441, B, SUMMERFIELD, FL 34491
(352) 307-0073
(352) 307-2073
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT 4913
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
OT4913
OT LICENSE NUMBER
FL
Enumeration date
04/29/2014
Last updated
04/29/2014
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